Most Americans Unaware of Open Enrollment Under Affordable Care Act

Open enrollment for 2017 coverage is over, and open enrollment for 2018 coverage will run from November 1, 2017 to December 15, 2017 (HHS plans to keep this same schedule in future years as well). For most people, that means the opportunity to purchase individual health insurance is very limited for the rest of the year. But there are still coverage options available.

All Native Americans can enroll year-round, as can people who qualify for Medicaid or CHIP. And applicants who experience a qualifying event gain access to a special open enrollment window to shop for plans in the exchange (or off-exchange, in most cases) with premium subsidies available in the exchange for eligible enrollees (note that HHS stepped up enforcement of special enrollment period eligibility verification in 2016, and has further increased the eligibility verification process in 2017; if you experience a qualifying event, be prepared to provide proof of it when you enroll)

But without a qualifying event, health insurance is not available outside of general open enrollment, on or off-exchange. (Nevada is an exception: off-exchange plans in Nevada are available for purchase year-round, but the carrier can impose a 90-day waiting period before coverage takes effect).

Unfortunately, this fact has caught many people by surprise over the last few years. And although the open enrollment period for 2017 coverage followed the same schedule as the one for 2016 coverage.

The first three open enrollment periods (2014, 2015, and 2016) all had different start and end dates, which further added to the confusion. The first open enrollment period was six months long; the second and third were both three months, but the dates were different.

For 2018, HHS had originally planned to keep the same November 1 – January 31 schedule, but a market stabilization rule finalized in April 2017 shortens open enrollment for 2018, scheduling it to run November 1, 2017 – December 15, 2017 (the same schedule that was already planned for 2019 coverage and beyond).

The change was not without controversy, as there’s disagreement in terms of whether a shorter open enrollment period for 2018 coverage will have a market stabilizing effect. California’s Insurance Commissioner, for example, believes it will do the opposite. And Colorado announced in June 2017 that they would add an extra four weeks at the end of the scheduled open enrollment period (state-run exchanges that have their own enrollment platform have some flexibility on issues like this that states using HealthCare.gov do not).

But for those who didn’t enroll in coverage by the end of open enrollment and aren’t expecting a qualifying event later in the year, the options for the rest of the year are limited to policies that are not regulated by the ACA. This includes short-term health insurance, some limited-benefit plans, accident supplements, critical/specific-illness policies, dental/vision plans, and medical discount plans.

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